Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review

(1) Background: Clinical reasoning is essential to the effective practice of autonomous health professionals and is, therefore, an essential capability to develop as students. This review aimed to systematically identify the tools available to health professional educators to evaluate students’ attainment of clinical reasoning capabilities in clinical placement and simulation settings. (2) Methods: A systemic review of seven databases was undertaken. Peer-reviewed, English-language publications reporting studies that developed or tested relevant tools were included. Searches included multiple terms related to clinical reasoning and health disciplines. Data regarding each tool’s conceptual basis and evaluated constructs were systematically extracted and analysed. (3) Results: Most of the 61 included papers evaluated students in medical and nursing disciplines, and over half reported on the Script Concordance Test or Lasater Clinical Judgement Rubric. A number of conceptual frameworks were referenced, though many papers did not reference any framework. (4) Conclusions: Overall, key outcomes highlighted an emphasis on diagnostic reasoning, as opposed to management reasoning. Tools were predominantly aligned with individual health disciplines and with limited cross-referencing within the field. Future research into clinical reasoning evaluation tools should build on and refer to existing approaches and consider contributions across professional disciplinary divides.

Occupational health care personnel tackling alcohol overuse – an observational study of work processes and patient characteristics

Background Overuse of alcohol is a significant risk factor for early retirement. This observational study investigated patient characteristics and work processes in occupational health care (OHC) affecting practices in tackling alcohol overuse. Methods The data were from 3089 patient contacts gathered for quality improvement purposes in fifteen OHC units during the years 2013–2019 in Finland. A two-proportion z-test was performed to find associations between reason for contact, and 17 other factors, and the probability of alcohol use being checked and overuse tackled. Results OHC personnel checked alcohol use twice as often with male patients as with female patients. Employees at risk of needing sick leave were checked for alcohol use more often (55.4, 95% confidence interval 49.2–61.6%) than those on > 30-day sick leave or working with permanent work disability (p < 0.01). Alcohol use was checked in 64.1% (59.5–68.7%) of patients while making an individual health promotion plan compared to 36.9% of those without a plan (33.1–40.6%, p < 0.0001). Patients with depression were actively checked for alcohol use, especially in cases of major depression (72.7%, 64.0–81.0%). Work processes in which OHC should have been more active in checking and tackling alcohol use included assessing the need for rehabilitation (36.5%, 32.0–41.0%) and health check-ups (HCUs) for mental reasons (43.8%, 38.1–49.4%). HCUs where alcohol overuse was detected led to brief interventions to tackle the overuse in 58.1% (43.4–72.9%) of cases. Conclusions The study showed factors that increased OHC personnel’s practices in checking and tackling alcohol use and work processes where the activity should be improved. Discussions about alcohol use took place more often with working-aged men than women, the younger the more. OHC personnel checked actively alcohol use with patients in danger of sick leave, patients treated for depression, while making an individual health promotion plan, and in planned HCUs with a confirmed protocol. More improvement is needed to conduct brief interventions in disability prevention processes, and especially when overuse is detected.

Psychosocial Distress in Parents with Children Awaiting Surgery during the COVID-19 Pandemic

Due to resource restrictions related to the COVID-19 pandemic, many pediatric patients are facing substantial delays for surgery, potentially resulting in additional distress for caregivers. We aimed to assess the experiences and psychosocial distress of parents during COVID-19 as they relate to the pandemic, waiting for surgery, and the combined effects of both events. The was a cross-sectional qualitative study. Parents with children who faced treatment delays during the initial wave of the COVID-19 pandemic for elective, non-emergent procedures across a variety of surgical specialties were recruited. Semi-structured telephone interviews and thematic analysis were utilized. Thematic saturation was reached with eighteen participants. Four themes were identified: coping with COVID-19, distress levels, quality and nature of communication with the surgical team, and the experience of COVID-19 related hospital restrictions. Participants reported varying levels of distress due to the delay in surgery, such as the fear of developmental delay or disease progression for their child. They also indicated their own physical and mental health had been impacted by emotional distress related to both COVID-19 and delays in treatment. Most participants experienced the COVID-19-related hospital restrictions as distressing. This related predominantly to limiting in-hospital caregivers to only one caregiver. Participants were found to have substantial levels of psychosocial distress. Targeted social and emotional support may be helpful in reducing parental distress as the pandemic timeframe continues. Within the limits of individual health systems, reducing restrictions to the number of allowed care givers may help allay distress felt by parents.

A Research on Perceptions of Health News of Individuals Who Lived in Istanbul in the COVID-19 Process

Health communication is a field that is increasing in importance and developing in public health and non-profit organizations and the business sector. COVID-19 is a new type of virus that affects the whole world and is diagnosed with fever, dry cough, malaise, and symptoms of dyspnea. This research was formed to masculate their perceptions related to individual health news in Istanbul. The study sample was formed by adults, individuals aged over 18 years, who lived in Istanbul. The research has been applied by personal information forms and perceptions of health news scale.

The impact of misinformation on the COVID-19 pandemic

<abstract> <p>Since the inception of the current pandemic, COVID-19 related misinformation has played a role in defaulting control of the situation. It has become evident that the internet, social media, and other communication outlets with readily available data have contributed to the dissemination and availability of misleading information. It has perpetuated beliefs that led to vaccine avoidance, mask refusal, and utilization of medications with insignificant scientific data, ultimately contributing to increased morbidity. Undoubtedly, misinformation has become a challenge and a burden to individual health, public health, and governments globally. We performed a literature search of databases such as Pubmed, Google, GoogleScholar. The key descriptors used for the search purposes were “COVID-19”, “Coronavirus”, “SARS-CoV-2”, “communication”, “healthcare”, “misinformation”, and “social media”. This literature review aims at providing an overview and summary regarding the role of media, other information outlets, and their impact on the pandemic. The goal of this article is to increase awareness of the negative impact of misinformation on the pandemic. In addition, we discuss a few recommendations that could aid in decreasing this burden, as preventing the conception and dissemination of misinformation is essential.</p> </abstract>

The Impact of the Judicialization of the Unique Health System

This study aims to discuss the right to health, comparing collective and individual health and analyzing the impact of judicialization on the Unified Health System (SUS). Therefore, it addresses the right to health, presenting its concept and minimum content; discusses the principle of integrality; discusses the judicial control of public policies, weighing up the reserve of the possible and the minimum existential; and defends the prioritization of public policies that benefit the community. As a methodology, bibliographic research was adopted based on the literary review of books, articles and legislation that are dedicated to the theme in order to seek solutions to reduce expenses with judicialization.

On the Intergenerational Transmission of Health Inequality

Cumulating evidence from social science has indicated the intergenerational transmission of inequality is majorly derived from the economic imbalance. In line with this, the same thing happens in health, and emerging evidence has been documenting its transmissible property. No matter the genetic or non-genetic causes, health inequality inevitably plays its role in contributing to the underlying health-associated despoliation in life. Each individual shows an eventual health state where equality and inequality reach a time-dependent temporary condition in which the balancing point fluctuates back and forth. To promote the overall health status, it is crucial to promote and optimize the positive health characteristics to get equilibrium between positive and negative. This review discussed the underlying mechanisms of intergenerational transmission of health inequality by focusing on different types of contributors to the inequality and providing prospective insights into the potentially beneficial strategies that can optimize overall individual health.

Characterization of the Gastrointestinal and Reproductive Tract Microbiota in Fertile and Infertile Pakistani Couples

The human microbiota is recognized as a vital “virtual” organ of the human body that influences human health, metabolism, and physiology. While the microbiomes of the gut, oral cavity, and skin have been extensively studied in the literature, relatively little work has been done on characterizing the microbiota of the human reproductive tract organs, and specifically on investigating its association to fertility. Here, we implemented a 16S ribosomal RNA (rRNA) amplicon sequencing approach to sequence and characterize the gut and genital tract microbiomes from several married Pakistani couples. The recruited individuals included 31 fertile and 35 infertile individuals, with ages ranging from 19–45 years. We identified several fluctuations in the diversity and composition of the gut and genital microbiota among fertile and infertile samples. For example, measures of α-diversity varied significantly between the genital samples donated by fertile and infertile men and there was overall greater between-sample variability in genital samples regardless of gender. In terms of taxonomic composition, Actinobacteria, Bacteroidetes, and Firmicutes fluctuated significantly between the gut microbiomes of fertile and infertile samples. Finally, biomarker analyses identified features (genera and molecular functions and pathways) that differed significantly between the fertile and infertile samples and in the past have been associated with bacterial vaginosis. However, we emphasize that 16S amplicon data alone has no bearing on individual health and is merely representative of microbial taxonomic differences that could also arise due to multiple other factors. Our findings, however, represent the first effort to characterize the microbiome associated with fertile and infertile couples in Pakistan and will hopefully pave the way for more comprehensive and broad-scale investigations in the future.

Maternal opioid use is reflected on leukocyte telomere length of male newborns

Opioid use accelerates normal aging in adults that raises a question on whether it may trans-generationally affect aging and aging biomarkers in the offspring of users as well? In the present research, we investigated the relative telomere length in umbilical cord blood of newborns born to opioid consuming mothers compared to normal controls. Telomere length shortening is a known biomarker of aging and aging related diseases. Its measure at birth or early in life is considered as a predictor of individual health in adulthood. Here, we performed a case-control study to investigate whether maternal opioid use affects newborns relative telomere length (RTL). 57 mother-newborn dyads were included in this study, 30 neonates with opioid using mothers (OM), and 27 with not-opioid using mothers (NOM)). RTL was measured in leukocyte cells genomic DNA using real-time PCR. The correlation of maternal opioid use with neonates telomer length was assessed using logistic regression analysis. The results displayed a significant association between odds ratio of long RTL and maternal opioid use when sensitivity analysis was performed by neonate sex; where the data indicates significantly increased odds ratio of long leukocyte RTL in association with maternal opioid use in male neonates only. Further work is necessary to assess this association in larger samples and test the potential underlying mechanisms for this observation.

ANALISIS KELENGKAPAN STANDAR INSTALASI LABORATORIUM DI RSIA ERIA BUNDA PEKANBARU TAHUN

Laboratorium klinik adalah laboratorium kesehatan yang melaksanakan pelayanan, pemeriksaan specimen klinik untuk mendapatkan informasi tentang kesehatan perorangan terutama untuk menunjang upaya diagnosis penyakit, penyembuhan penyakit, dan pemulihan kesehatan.Tujuan penelitian ini secara umum untuk mengetahui Analisi Kelengkapan Standar Instalasi Laboratorium di RSIA Eria Bunda Pekanbaru Tahun 2020.Dilakukan wawancara mendalam dan observasi kepada 5 informan.Lokasi penelitian dilakukan di RSIA Eria Bunda Pekanbaru di jln.K.H.Ahmad Dahlan No.163 Sukajadi Pekanbaru, Riau, khususnya dibagian laboratorium pada bulan Maret-April 2020.Hasil penelitian menunjukkan bahwa SDM di laboratorium belum sesuai dengan standar, Sarana di laboratorium belum sesuai dengan standar, Prasarana di laboratorium belum sesuai dengan standar, dan SOP di laboratorium belum sesuai dengan standarnya. Dari hasil penelitian dapat disimpulkan bahwa SDM di laboratorium masih perlu penambahan SDM atau memaksimalkan SDM yang ada dengan menggatur ulang jadwal shiff, Sarana di laboratorium harus dilengkapi dari ruang-ruangan sampai alat laboratorium, Prasarana menyediakan KM/WC untuk pasien dan petugas secara terpisah disekitar laboratorium, dan SOP di laboratorium perlu adanya pengawasan untuk staf analis dalam menerapkan SOP di RSIA Eria Bunda Pekanbaru Tahun 2020. A clinical laboratory is a health laboratory that provides service, examines clinical specimen to obtain information on individual health, especially to support effort to diagnose disease, cures disease and restores health. The purpose of this study generally was to determine the analysis of standard completeness of laboratory installation at RSIA Eria Bunda Pekanbaru in 2020. In-depth interview and observation were conducted with 5 informants. The location of the research was carried out at RSIA Eria Bunda Pekanbaru on KH. Ahmad Dahlan street No.163 Sukajadi Pekanbaru, Riau, especially in the laboratory section on March-April 2020. The result showed that the human resources in the laboratory were not in accordance with standard, the facility in the laboratory was not in accordance with the standard, the infrastructure in the laboratory was not in accordance with the standard, and SOP in the laboratory was not in accordance with the standard. From the result of the study it can be concluded that the human resources in the laboratory still need to add more human resources or maximize existing human resources by resetting the shiff schedule, the facility in the laboratory must be equipped from rooms to laboratory equipment, infrastructure provides bathroom /toilet for patient and staff separately around the laboratory , and SOP in the laboratory needs supervision for analizing staff in implementing SOP at RSIA Eria Bunda Pekanbaru in 2020.